It leaves little incentive for insurers to keep participating in ACA exchanges to enable a “smooth transition” in 2020.

It breaks every promise Trump has made, notably: “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now” and “You will end up with great health care for a fraction of the price.”

Its "continuous coverage" punishes people with a 30% tax, far more onerous than the Individual Mandate and so large people will not be able to afford getting back into coverage.

Its CBO score is so startling that it is being kept secret.

Its impact on coverage, public health, access and affordability will revert America to developing country levels of coverage and health outcomes. Let us all hope that Republicans go back to the drawing board and return with a proposal that preserves coverage, enables patients to keep their doctors, tackles total cost of care, and works to make premiums more affordable with age and income adjusted tax credits.

We can do so much better. And the AHCA would be a tragic step backwards.